Provider Demographics
NPI:1518454008
Name:BEATTY, LORI SUE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:SUE
Last Name:BEATTY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WALNUT LN
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-9481
Mailing Address - Country:US
Mailing Address - Phone:240-338-5063
Mailing Address - Fax:
Practice Address - Street 1:2360 SWEETEN CREEK RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2030
Practice Address - Country:US
Practice Address - Phone:828-274-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8616225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation